Provider Demographics
NPI:1144552753
Name:HACKER, MARGARET SUSAN (RN)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:SUSAN
Last Name:HACKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-5117
Mailing Address - Country:US
Mailing Address - Phone:607-351-0438
Mailing Address - Fax:
Practice Address - Street 1:18 DAVID DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-5117
Practice Address - Country:US
Practice Address - Phone:607-351-0438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-06
Last Update Date:2010-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY462487-1163W00000X, 163WH0200X
NY467487-1163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health